Article Text

Unusual association of diseases/symptoms
Skin rash, headache and abnormal behaviour: unusual presentation of intracranial haemorrhage in dengue fever
  1. Abdul Majid Wani1,
  2. Mousa Ali Al Mejally2,
  3. Waleed Mohd Hussain1,
  4. Wail Al Maimani1,
  5. Sadia Hanif1,
  6. Amer Mohd Khoujah3,
  7. Ahmad Siddiqi1,
  8. Mubeena Akhtar1,
  9. Mazen G Bafaraj4,
  10. Khurram Fareed5
  1. 1
    Hera General Hospital, Medicine, 4a/201, Makkah, Western, 21955, Saudi Arabia
  2. 2
    Hera General Hospital, Medicine, Makka-KSA, Makkah, PO Box 20993, Saudi Arabia
  3. 3
    National Guard Hospital, Medicine, Jeddah, 21955, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
  4. 4
    Umm Al-Qura University, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
  5. 5
    Hera General Hospital, ER, Makkah, 21955, Saudi Arabia
  1. Abdul Majid Wani, dr_wani_majid{at}


Dengue viral infections are one of the most important mosquito borne diseases in the world. The dengue virus is a single stranded RNA virus belonging to the Flaviviridae family. There are four serotypes (DEN 1–4) classified according to biological and immunological criteria. Patients may be asymptomatic or their condition may give rise to undifferentiated fever, dengue fever, dengue haemorrhagic fever (DHF), or dengue shock syndrome. Annually, 100 million cases of dengue fever and half a million cases of DHF occur worldwide and 2.5 billion people are at risk. At present, dengue is endemic in 112 countries. Early recognition and prompt initiation of appropriate treatment are vital if disease related morbidity and mortality are to be limited. We present an interesting case of dengue fever with headache, skin rash and abnormal behaviour who had a massive intracranial haemorrhage with fatal outcome.

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  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.